How New York licenses assisted living around Rochester

Who licenses assisted living in Rochester, New York?

The New York State Department of Health (NYSDOH) licenses and inspects every adult care facility in Rochester and the surrounding counties; there is no city or county license, and the department's Western Regional Office, Rochester Area, at 1565 Jefferson Road handles the region.

New York does not issue a license called “assisted living.” What the department licenses is an adult care facility, and the two types families meet around Rochester are the adult home (18 NYCRR Part 487) and the enriched housing program (Part 488). A third type, the residence for adults (Part 490), is rare and mostly serves people with mental health needs. Every building then decides whether to add assisted living certifications on top of that base license.

What is the difference between an adult home and an enriched housing program?

An adult home provides room, meals, housekeeping, personal care and round-the-clock supervision to five or more adults in a congregate building, while an enriched housing program provides personal care and supervision fewer than 24 hours a day to residents, mostly 65 or older, living in apartment-style units with at least one hot meal a day.

In practice the line has blurred: many Rochester-area enriched housing buildings run 24-hour staff anyway, and several campuses hold both licenses under one roof. The license tells you the floor the state enforces, not the ceiling a particular operator offers. The Department of Health's roster lists 46 licensed adult care facility buildings in Monroe, Ontario, Wayne, Livingston and Orleans counties, with 3,632 certified beds: 31 hold an adult home license and 16 an enriched housing license (a few hold both), and 31 are certified as Assisted Living Residences.

What do ALR, EALR, SNALR and ALP mean on a New York license?

They are certifications added to an adult home or enriched housing license: an Assisted Living Residence (ALR) is the base assisted living certification under Public Health Law Article 46-B, an Enhanced ALR (EALR) lets residents age in place with heavier physical needs, a Special Needs ALR (SNALR) serves people with dementia, and the Assisted Living Program (ALP) is a Medicaid-paid package of services.

Each certification is counted in beds. A residence might hold 120 ALR beds, of which 24 are also EALR and 30 are SNALR. That bed count, published every quarter in the department's Adult Care Facility Quarterly Statistical Report, is the most reliable way to see what a building can legally do.

Source: NYSDOH Adult Care Facility Quarterly Statistical Information Report, 2026 Q2.

How often does New York inspect adult care facilities?

Social Services Law 461-a requires at least one unannounced inspection of each adult care facility every year, except that facilities holding the department's highest rating may go up to 18 months between full inspections.

On top of that cycle, the department investigates complaints, and those complaint surveys make up most of the visits on a typical Rochester-area residence's record. Each inspection report, with the number of violations and the regulation topics cited, is posted on NYS Health Profiles for a rolling four-year window. Our facility pages reproduce that list for every licensed building.

Does a residence need a separate license to call itself memory care?

No, but to admit and keep residents with dementia who need a specialized setting, a New York residence must hold Special Needs Assisted Living Residence (SNALR) certification with a dementia plan the department has approved; the words memory care on a brochure carry no legal weight by themselves.

In the department's 2026 Q2 capacity report, 27 of the 46 licensed residences in the five counties hold SNALR certification, with 793 SNALR beds between them; 3 are certified SNALR for every bed. See New York's memory care rules for what the certification requires.